1487979811 NPI number — HAMILTON HEALTH CENTER

Table of content: (NPI 1487979811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487979811 NPI number — HAMILTON HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAMILTON HEALTH CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487979811
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1695 N SUNRISE WAY SPC 7
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92262-3701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-327-1863
Provider Business Mailing Address Fax Number:
760-322-3208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1695 N SUNRISE WAY SPC 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-327-1863
Provider Business Practice Location Address Fax Number:
760-322-3208
Provider Enumeration Date:
03/29/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
JOY
Authorized Official Middle Name:
MICHELE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
760-327-1863

Provider Taxonomy Codes

  • Taxonomy code: 2081S0010X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A788470 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".